Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia.
Background Trachoma recrudescence after elimination as a public health problem has been reached is a concern for control programs globally. Programs typically conduct district-level trachoma surveillance surveys (TSS) ≥ 2 years after the elimination threshold is achieved to determine whether the pre...
Published in: | PLOS Neglected Tropical Diseases |
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ftdoajarticles:oai:doaj.org/article:e5872efd4b1743adb0b2aa7a4119954f 2024-09-09T19:28:10+00:00 Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia. Eshetu Sata Fikre Seife Zebene Ayele Sarah A Murray Karana Wickens Phong Le Mulat Zerihun Berhanu Melak Ambahun Chernet Kimberly A Jensen Demelash Gessese Taye Zeru Adisu Abebe Dawed Hiwot Debebe Zerihun Tadesse E Kelly Callahan Diana L Martin Scott D Nash 2024-02-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0011986 https://doaj.org/article/e5872efd4b1743adb0b2aa7a4119954f EN eng Public Library of Science (PLoS) https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011986&type=printable https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0011986 https://doaj.org/article/e5872efd4b1743adb0b2aa7a4119954f PLoS Neglected Tropical Diseases, Vol 18, Iss 2, p e0011986 (2024) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2024 ftdoajarticles https://doi.org/10.1371/journal.pntd.0011986 2024-08-05T17:49:50Z Background Trachoma recrudescence after elimination as a public health problem has been reached is a concern for control programs globally. Programs typically conduct district-level trachoma surveillance surveys (TSS) ≥ 2 years after the elimination threshold is achieved to determine whether the prevalence of trachomatous inflammation-follicular (TF) among children ages 1 to 9 years remains <5%. Many TSS are resulting in a TF prevalence ≥5%. Once a district returns to TF ≥5%, a program typically restarts costly mass drug administration (MDA) campaigns and surveys at least twice, for impact and another TSS. In Amhara, Ethiopia, most TSS which result in a TF ≥5% have a prevalence close to 5%, making it difficult to determine whether the result is due to true recrudescence or to statistical variability. This study's aim was to monitor recrudescence within Amhara by waiting to restart MDA within 2 districts with a TF prevalence ≥5% at TSS, Metema = 5.2% and Woreta Town = 5.1%. The districts were resurveyed 1 year later using traditional and alternative indicators, such as measures of infection and serology, a "wait and watch" approach. Methods/principal findings These post-surveillance surveys, conducted in 2021, were multi-stage cluster surveys whereby certified graders assessed trachoma signs. Children ages 1 to 9 years provided a dried blood spot and children ages 1 to 5 years provided a conjunctival swab. TF prevalence in Metema and Woreta Town were 3.6% (95% Confidence Interval [CI]:1.4-6.4) and 2.5% (95% CI:0.8-4.5) respectively. Infection prevalence was 1.2% in Woreta Town and 0% in Metema. Seroconversion rates to Pgp3 in Metema and Woreta Town were 0.4 (95% CI:0.2-0.7) seroconversions per 100 child-years and 0.9 (95% CI:0.6-1.5) respectively. Conclusions/significance Both study districts had a TF prevalence <5% with low levels of Chlamydia trachomatis infection and transmission, and thus MDA interventions are no longer warranted. The wait and watch approach represents a surveillance strategy which ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 18 2 e0011986 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Eshetu Sata Fikre Seife Zebene Ayele Sarah A Murray Karana Wickens Phong Le Mulat Zerihun Berhanu Melak Ambahun Chernet Kimberly A Jensen Demelash Gessese Taye Zeru Adisu Abebe Dawed Hiwot Debebe Zerihun Tadesse E Kelly Callahan Diana L Martin Scott D Nash Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Trachoma recrudescence after elimination as a public health problem has been reached is a concern for control programs globally. Programs typically conduct district-level trachoma surveillance surveys (TSS) ≥ 2 years after the elimination threshold is achieved to determine whether the prevalence of trachomatous inflammation-follicular (TF) among children ages 1 to 9 years remains <5%. Many TSS are resulting in a TF prevalence ≥5%. Once a district returns to TF ≥5%, a program typically restarts costly mass drug administration (MDA) campaigns and surveys at least twice, for impact and another TSS. In Amhara, Ethiopia, most TSS which result in a TF ≥5% have a prevalence close to 5%, making it difficult to determine whether the result is due to true recrudescence or to statistical variability. This study's aim was to monitor recrudescence within Amhara by waiting to restart MDA within 2 districts with a TF prevalence ≥5% at TSS, Metema = 5.2% and Woreta Town = 5.1%. The districts were resurveyed 1 year later using traditional and alternative indicators, such as measures of infection and serology, a "wait and watch" approach. Methods/principal findings These post-surveillance surveys, conducted in 2021, were multi-stage cluster surveys whereby certified graders assessed trachoma signs. Children ages 1 to 9 years provided a dried blood spot and children ages 1 to 5 years provided a conjunctival swab. TF prevalence in Metema and Woreta Town were 3.6% (95% Confidence Interval [CI]:1.4-6.4) and 2.5% (95% CI:0.8-4.5) respectively. Infection prevalence was 1.2% in Woreta Town and 0% in Metema. Seroconversion rates to Pgp3 in Metema and Woreta Town were 0.4 (95% CI:0.2-0.7) seroconversions per 100 child-years and 0.9 (95% CI:0.6-1.5) respectively. Conclusions/significance Both study districts had a TF prevalence <5% with low levels of Chlamydia trachomatis infection and transmission, and thus MDA interventions are no longer warranted. The wait and watch approach represents a surveillance strategy which ... |
format |
Article in Journal/Newspaper |
author |
Eshetu Sata Fikre Seife Zebene Ayele Sarah A Murray Karana Wickens Phong Le Mulat Zerihun Berhanu Melak Ambahun Chernet Kimberly A Jensen Demelash Gessese Taye Zeru Adisu Abebe Dawed Hiwot Debebe Zerihun Tadesse E Kelly Callahan Diana L Martin Scott D Nash |
author_facet |
Eshetu Sata Fikre Seife Zebene Ayele Sarah A Murray Karana Wickens Phong Le Mulat Zerihun Berhanu Melak Ambahun Chernet Kimberly A Jensen Demelash Gessese Taye Zeru Adisu Abebe Dawed Hiwot Debebe Zerihun Tadesse E Kelly Callahan Diana L Martin Scott D Nash |
author_sort |
Eshetu Sata |
title |
Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia. |
title_short |
Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia. |
title_full |
Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia. |
title_fullStr |
Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia. |
title_full_unstemmed |
Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia. |
title_sort |
wait and watch: a trachoma surveillance strategy from amhara region, ethiopia. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2024 |
url |
https://doi.org/10.1371/journal.pntd.0011986 https://doaj.org/article/e5872efd4b1743adb0b2aa7a4119954f |
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Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 18, Iss 2, p e0011986 (2024) |
op_relation |
https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011986&type=printable https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0011986 https://doaj.org/article/e5872efd4b1743adb0b2aa7a4119954f |
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https://doi.org/10.1371/journal.pntd.0011986 |
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